Vilar Lucio, Moura Eliane, Canadas Viviane, Gusmão Amaro, Campos Renata, Leal Edmundo, Teixeira Luciano, Santos Vera, Gomes Barbara, Lima Marise, Paiva Renata, Albuquerque José Luciano, Egito Célia S, Botelho Carlos A, Azevedo Monalisa, Casulari Luiz Augusto, Naves Luciana A
Serviço de Endocrinologia, Hospital das Clínicas, Universidade Federal de Pernambuco.
Arq Bras Endocrinol Metabol. 2007 Feb;51(1):86-91. doi: 10.1590/s0004-27302007000100014.
Macroprolactinemia is characterized by the predominance in the serum of macroprolactin, a prolactin (PRL) with high molecular mass and low biological activity that does not need treatment. The prevalence of macroprolactinemia was evaluated in 115 consecutive patients with hyperprolactinemia. Among them, 19 (16.5%) had solely macroprolactinemia, 4 (3.5%) polycystic ovary syndrome, 7 (6.1%) acromegaly, 8 (6.9%) idiopathic hyperprolactinemia, 10 (8.6%) primary hypothyroidism, 14 (12.2%) clinically non-functioning pituitary adenomas, 20 (17.4%) drug-induced hyperprolactinemia and 33 (28.7%) prolactinomas. The diagnosis of macroprolactinemia was established by the demonstration of a PRL recovery < 30% after treatment of sera with polyethylene glycol. Among the 19 patients with isolated macroprolactinemia, 16 (84.2%) were female and 12 (63.2%) were asymptomatic, while 4 (21%) presented with oligomenorrhea and 3 (15.8%) with galactorrhea. In contrast, only 11.5% of individuals with other causes of hyperprolactinemia were asymptomatic (p< 0.001). Prolactin levels in cases of macroprolactin ranged from 45.1 to 404 ng/mL (mean 113.3 +/- 94.5) but in 15 (78.9%) were < 100 ng/mL. Our findings demonstrate that macroprolactinemia is a common condition and, therefore, we suggest that it should be routinely screened in patients with hyperprolactinemia.
巨泌乳素血症的特征是血清中以巨泌乳素为主，巨泌乳素是一种高分子量、低生物活性的泌乳素（PRL），无需治疗。对115例连续的高泌乳素血症患者评估了巨泌乳素血症的患病率。其中，19例（16.5%）仅患有巨泌乳素血症，4例（3.5%）患有多囊卵巢综合征，7例（6.1%）患有肢端肥大症，8例（6.9%）患有特发性高泌乳素血症，10例（8.6%）患有原发性甲状腺功能减退症，14例（12.2%）患有临床无功能垂体腺瘤，20例（17.4%）患有药物性高泌乳素血症，33例（28.7%）患有泌乳素瘤。通过用聚乙二醇处理血清后PRL回收率<30%来确立巨泌乳素血症的诊断。在19例孤立性巨泌乳素血症患者中，16例（84.2%）为女性，12例（63.2%）无症状，4例（21%）表现为月经过少，3例（15.8%）表现为溢乳。相比之下，其他原因导致的高泌乳素血症患者中只有11.5%无症状（p<0.001）。巨泌乳素血症患者的泌乳素水平范围为45.1至404 ng/mL（平均113.3±94.5），但15例（78.9%）<100 ng/mL。我们的研究结果表明，巨泌乳素血症是一种常见病症，因此，我们建议对高泌乳素血症患者应常规筛查该病。
